Catheter brachytherapy provides internal radiotherapy treatment to a subject, whereby a radioactive source is advanced along a catheter which tip is inserted close to a region of treatment. It is commonly used to treat oesophageal and uterine cancers, and head and neck cancers. Catheter brachytherapy is well known in the art. Clinical studies indicate that brachytherapy is an effective treatment for reducing size and rate of growth of cancers, in palliative care as well as in curative indications.
For some indications, such as in esophageal cancer, catheter brachytherapy entails that a skilled practitioner introduces a guidewire into the subject using a visualizing instrument such as an endoscope, to ensure the correct route and position of the guidewire. Once the guidewire is positioned, a catheter is introduced using the guidewire, and appropriately positioned into the subject. A radiation source attached to the end of a source wire is then advanced through the catheter so that the radiation source reaches the treatment site and can deliver an effective dose of radiation. After the radiation treatment, the radiation source is removed. The catheter cannot remain in place for subsequent treatments and is thus removed. The insertion procedure must be repeated again for each treatment session.
The particular procedure is highly traumatic for the subject, as it can take some time to position the catheter, and also to avoid infection in the case of incision entry. When treating esophageal cancer, the catheter is passed though the oral cavity and throat; it typically has a large diameter, producing severe discomfort owing to a choking and/or gagging sensation. Typically the subject must be sedated. In addition, the catheter must remain in place throughout the course of the treatment during which time the patient is in constant distress. Furthermore, brachytherapy sometimes has to be fractionated i.e. repeated several times in subsequent visits, which fractionated treatment is more efficaceaous and less toxic. This means that this painful procedure has to be imposed on a patient several times. There is a limit to what a patient can endure; therefore, fractionated treatment must be restricted, and, can be considered only to boost the treated area after external radiotherapy. There is a need to develop a way to perform user-friendly, brachytherapy that is less traumatic for the patient.
The present invention provides a new method and kit for performing catheter brachytherapy which overcomes the problem of patient discomfort and stress during a course of treatment, and facilitates fractionated treatment.